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儿童和青少年的饮食摄入与心血管代谢危险因素的前瞻性变化

Dietary intake and prospective changes in cardiometabolic risk factors in children and youth.

作者信息

Setayeshgar Solmaz, Ekwaru John Paul, Maximova Katerina, Majumdar Sumit R, Storey Kate E, McGavock Jonathan, Veugelers Paul J

机构信息

a School of Public Health, Population Health Intervention Research Unit, University of Alberta, 3-50 University Terrace, 8303 112 Street, Edmonton, AB T6G 2T4, Canada.

b School of Public Health, University of Alberta, 3-268 Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, AB T6G 1C9, Canada.

出版信息

Appl Physiol Nutr Metab. 2017 Jan;42(1):39-45. doi: 10.1139/apnm-2016-0215. Epub 2016 Dec 13.

Abstract

Only few studies examined the effect of diet on prospective changes in cardiometabolic (CM) risk factors in children and youth despite its importance for understanding the role of diet early in life for cardiovascular disease in adulthood. To test the hypothesis that dietary intake is associated with prospective changes in CM risk factors, we analyzed longitudinal observations made over a period of 2 years among 448 students (aged 10-17 years) from 14 schools in Canada. We applied mixed effect regression to examine the associations of dietary intake at baseline with changes in body mass index, waist circumference (WC), systolic and diastolic blood pressure (SBP and DBP), and insulin sensitivity score between baseline and follow-up while adjusting for age, sex, and physical activity. Dietary fat at baseline was associated with increases in SBP and DBP z scores (per 10 g increase in dietary fat per day: β = 0.03; p < 0.05) and WC (β = 0.31 cm; p < 0.05) between baseline and follow-up. Every additional gram of sodium intake at baseline was associated with an increase in DBP z score of 0.04 (p < 0.05) between baseline and follow-up. Intake of sugar, vegetables and fruit, and fibre were not associated with changes in CM risk factors in a statistically significant manner. Our findings suggest that a reduction in the consumption of total dietary fat and sodium may contribute to the prevention of excess body weight and hypertension in children and youth, and their cardiometabolic sequelae later in life.

摘要

尽管饮食对理解儿童和青少年时期的饮食在成年后心血管疾病中的作用至关重要,但只有少数研究探讨了饮食对儿童和青少年心脏代谢(CM)危险因素前瞻性变化的影响。为了检验饮食摄入与CM危险因素前瞻性变化相关的假设,我们分析了加拿大14所学校448名学生(10 - 17岁)在2年期间的纵向观察数据。我们应用混合效应回归来检验基线时的饮食摄入与基线至随访期间体重指数、腰围(WC)、收缩压和舒张压(SBP和DBP)以及胰岛素敏感性评分变化之间的关联,同时调整年龄、性别和身体活动。基线时的膳食脂肪与基线至随访期间SBP和DBP z评分的增加相关(每日膳食脂肪每增加10克:β = 0.03;p < 0.05)以及WC增加(β = 0.31厘米;p < 0.05)。基线时每额外摄入1克钠与基线至随访期间DBP z评分增加0.04相关(p < 0.05)。糖、蔬菜和水果以及纤维的摄入量与CM危险因素的变化无统计学显著关联。我们的研究结果表明,减少膳食总脂肪和钠的摄入量可能有助于预防儿童和青少年的超重和高血压及其在生命后期的心脏代谢后遗症。

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